What is the difference between conventional and CT coronary angiography?

An angiogram can be done with x-rays, computerized tomography (CT) scans and magnetic resonance imaging (MRI). Angiograms use contrast to look at veins or arteries. Contrast is delivered using an IV through a vein. In a coronary angiogram, which is generally done by a cardiologist, a catheter is placed into an artery in the groin or wrist. The arteries in the heart are filled with contrast in order for the cardiologist to look at them.

Dr. Mark B. Lampert, MD
Cardiologist (Heart Specialist)

CT coronary angiography is the process of looking at a CAT scan of the coronary arteries while the heart is moving. Learn more from Dr. Mark Lampert on behalf of NorthShore University HealthSystem about CT coronary angiography.

When cardiologists talk about coronary angiography, they usually mean conventional invasive angiography. It is called invasive because it involves puncturing the skin with a large needle; inserting a slender tube, or catheter, into an artery in the groin or wrist; threading the catheter into the heart; injecting contrast dye into the coronary arteries; viewing the arteries with x-rays and recording those images digitally.

During the procedure, patients are awake but sedated. Afterward, they must lie still for several hours while pressure is applied to the puncture wound used to insert the catheter. This is done to prevent excessive bleeding.

CT angiography is considered noninvasive, since the only puncture comes from the small needle used for placing an intravenous line in the hand or arm. The intravenous line will be used to inject contrast dye and, in some cases, medication to slow the heart rate. During the procedure, the patient lies on a table that glides through a large tube. This tube, which contains an x-ray camera, rotates around and around as it captures images of the heart in narrow sections called slices. A computer puts together all the data and creates detailed pictures of the heart and blood vessels.

Invasive coronary angiography has been used for decades to see inside the arteries. It is considered the gold standard for diagnosing coronary artery disease, and is especially useful in higher-risk patients who are likely to need a procedure to open clogged coronary arteries.

CT angiography has made huge strides in recent years and, in some cardiology practices, is taking the place of nuclear stress testing for the initial evaluation of low- or intermediate-risk patients.

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